Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 52.297
Filtrar
1.
Medicine (Baltimore) ; 100(36): e26855, 2021 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-34516488

RESUMEN

ABSTRACT: Coronavirus disease (COVID-19) has spread worldwide. X-ray and computed tomography (CT) are 2 technologies widely used in image acquisition, segmentation, diagnosis, and evaluation. Artificial intelligence can accurately segment infected parts in X-ray and CT images, assist doctors in improving diagnosis efficiency, and facilitate the subsequent assessment of the severity of the patient infection. The medical assistant platform based on machine learning can help radiologists make clinical decisions and helper in screening, diagnosis, and treatment. By providing scientific methods for image recognition, segmentation, and evaluation, we summarized the latest developments in the application of artificial intelligence in COVID-19 lung imaging, and provided guidance and inspiration to researchers and doctors who are fighting the COVID-19 virus.


Asunto(s)
COVID-19/diagnóstico por imagen , Aprendizaje Automático , Neumonía Viral/diagnóstico por imagen , SARS-CoV-2 , Humanos , Radiografía , Tomografía Computarizada por Rayos X
3.
FASEB J ; 35(9): e21801, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34365657

RESUMEN

The spike protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) plays a crucial role in mediating viral entry into host cells. However, whether it contributes to pulmonary hyperinflammation in patients with coronavirus disease 2019 is not well known. In this study, we developed a spike protein-pseudotyped (Spp) lentivirus with the proper tropism of the SARS-CoV-2 spike protein on the surface and determined the distribution of the Spp lentivirus in wild-type C57BL/6J male mice that received an intravenous injection of the virus. Lentiviruses with vesicular stomatitis virus glycoprotein (VSV-G) or with a deletion of the receptor-binding domain (RBD) in the spike protein [Spp (∆RBD)] were used as controls. Two hours postinfection (hpi), there were 27-75 times more viral burden from Spp lentivirus in the lungs than in other organs; there were also about 3-5 times more viral burden from Spp lentivirus than from VSV-G lentivirus in the lungs, liver, kidney, and spleen. Deletion of RBD diminished viral loads in the lungs but not in the heart. Acute pneumonia was observed in animals 24 hpi. Spp lentivirus was mainly found in SPC+ and LDLR+ pneumocytes and macrophages in the lungs. IL6, IL10, CD80, and PPAR-γ were quickly upregulated in response to infection in the lungs as well as in macrophage-like RAW264.7 cells. Furthermore, forced expression of the spike protein in RAW264.7 cells significantly increased the mRNA levels of the same panel of inflammatory factors. Our results demonstrated that the spike protein of SARS-CoV-2 confers the main point of viral entry into the lungs and can induce cellular pathology. Our data also indicate that an alternative ACE2-independent viral entry pathway may be recruited in the heart and aorta.


Asunto(s)
Macrófagos/inmunología , Neumonía Viral/inmunología , Neumonía Viral/patología , Glicoproteína de la Espiga del Coronavirus/inmunología , Enfermedad Aguda , Células Epiteliales Alveolares/virología , Animales , Antígeno B7-1 , Línea Celular , Mediadores de Inflamación , Interleucina-10 , Interleucina-6 , Lentivirus/genética , Lentivirus/aislamiento & purificación , Lentivirus/metabolismo , Pulmón/inmunología , Pulmón/patología , Pulmón/virología , Macrófagos/virología , Masculino , Glicoproteínas de Membrana , Ratones , Ratones Endogámicos C57BL , PPAR gamma , Células RAW 264.7 , Glicoproteína de la Espiga del Coronavirus/química , Glicoproteína de la Espiga del Coronavirus/genética , Glicoproteína de la Espiga del Coronavirus/metabolismo , Proteínas del Envoltorio Viral
4.
J Immunol ; 207(5): 1229-1238, 2021 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-34348975

RESUMEN

Infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) or seasonal influenza may lead to respiratory failure requiring intubation and mechanical ventilation. The pathophysiology of this respiratory failure is attributed to local immune dysregulation, but how the immune response to viral infection in the lower airways of the human lung differs between individuals with respiratory failure and those without is not well understood. We used quantitative multiparameter flow cytometry and multiplex cytokine assays to evaluate matched blood and bronchoalveolar lavage (BAL) samples from control human subjects, subjects with symptomatic seasonal influenza who did not have respiratory failure, and subjects with severe seasonal influenza or SARS-CoV-2 infection with respiratory failure. We find that severe cases are associated with an influx of nonclassical monocytes, activated T cells, and plasmablast B cells into the lower airways. Cytokine concentrations were not elevated in the lower airways of moderate influenza patients compared with controls; however, 28 of 35 measured cytokines were significantly elevated in severe influenza, severe SARS-CoV-2 infection, or both. We noted the largest elevations in IL-6, IP-10, MCP-1, and IL-8. IL-1 family cytokines and RANTES were higher in severe influenza infection than severe SARS-CoV-2 infection. Interestingly, only the concentration of IP-10-correlated between blood and BAL during severe infection. Our results demonstrate inflammatory immune dysregulation in the lower airways during severe viral pneumonia that is distinct from lower airway responses seen in human patients with symptomatic, but not severe, illness and suggest that measurement of blood IP-10 concentration may predict this unique dysregulation.


Asunto(s)
COVID-19/inmunología , Virus de la Influenza A/fisiología , Neumonía Viral/inmunología , Sistema Respiratorio/inmunología , SARS-CoV-2/fisiología , Adulto , Anciano , Proteínas Sanguíneas/metabolismo , Líquido del Lavado Bronquioalveolar/inmunología , COVID-19/diagnóstico , Quimiocina CXCL10/metabolismo , Estudios de Cohortes , Femenino , Humanos , Mediadores de Inflamación/metabolismo , Gripe Humana/inmunología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Insuficiencia Respiratoria , Índice de Severidad de la Enfermedad
5.
Fam Pract ; 38(Suppl 1): i16-i22, 2021 Aug 27.
Artículo en Inglés | MEDLINE | ID: mdl-34448486

RESUMEN

BACKGROUND: Pandemics threaten lives and economies. This article addresses the global threat of the anticipated overlap of COVID-19 with seasonal-influenza. OBJECTIVES: Scientific evidence based on simulation methodology is presented to reveal the impact of a dual outbreak, with scenarios intended for propagation analysis. This article aims at researchers, clinicians of family medicine, general practice and policy-makers worldwide. The implications for the clinical practice of primary health care are discussed. Current research is an effort to explore new directions in epidemiology and health services delivery. METHODS: Projections consisted of machine learning, dynamic modelling algorithms and whole simulations. Input data consisted of global indicators of infectious diseases. Four simulations were run for '20% versus 60% flu-vaccinated populations' and '10 versus 20 personal contacts'. Outputs consisted of numerical values and mathematical graphs. Outputs consisted of numbers for 'never infected', 'vaccinated', 'infected/recovered', 'symptomatic/asymptomatic' and 'deceased' individuals. Peaks, percentages, R0, durations are reported. RESULTS: The best-case scenario was one with a higher flu-vaccination rate and fewer contacts. The reverse generated the worst outcomes, likely to disrupt the provision of vital community services. Both measures were proven effective; however, results demonstrated that 'increasing flu-vaccination rates' is a more powerful strategy than 'limiting social contacts'. CONCLUSIONS: Results support two affordable preventive measures: (i) to globally increase influenza-vaccination rates, (ii) to limit the number of personal contacts during outbreaks. The authors endorse changing practices and research incentives towards multidisciplinary collaborations. The urgency of the situation is a call for international health policy to promote interdisciplinary modern technologies in public health engineering.


Asunto(s)
COVID-19/epidemiología , Control de Enfermedades Transmisibles/organización & administración , Salud Global , Gripe Humana/epidemiología , Neumonía Viral/epidemiología , Práctica de Salud Pública , Vacunas contra la COVID-19/administración & dosificación , Simulación por Computador , Brotes de Enfermedades , Humanos , Vacunas contra la Influenza/administración & dosificación , Pandemias , Técnicas de Planificación , Neumonía Viral/virología , SARS-CoV-2
6.
S Afr Med J ; 111(6): 575-581, 2021 04 15.
Artículo en Inglés | MEDLINE | ID: mdl-34382570

RESUMEN

BACKGROUND: Empirical broad-spectrum antibiotics are frequently prescribed to patients with severe COVID-19, motivated by concern about bacterial coinfection. There is no evidence of benefit from such a strategy, while the dangers of inappropriate antibiotics are well described. OBJECTIVES: To investigate the frequency, profile and related outcomes of infections by bacterial pathogens in patients admitted to an intensive care unit (ICU) with severe COVID-19 pneumonia. METHODS: This was a prospective, descriptive study in a dedicated COVID-19 ICU in Cape Town, South Africa, involving all adult patients admitted to the ICU with confirmed COVID-19 pneumonia between 26 March and 31 August 2020. We collected data on patient comorbidities, laboratory results, antibiotic treatment, duration of admission and in-hospital outcome. RESULTS: We included 363 patients, who collectively had 1 199 blood cultures, 308 tracheal aspirates and 317 urine cultures performed. We found positive cultures for pathogens in 20 patients (5.5%) within the first 48 hours of ICU admission, while 73 additional patients (20.1%) had positive cultures later during their stay. The most frequently isolated pathogens at all sites were Acinetobacter baumannii (n=54), Klebsiella species (n=13) and coagulase-negative staphylococci (n=9). Length of ICU stay (p<0.001) and intubation (p<0.001) were associated with positive cultures on multivariate analysis. Disease severity (p=0.5), early antibiotic use (p=0.5), diabetes mellitus (p=0.1) and HIV (p=0.9) were not associated with positive cultures. Positive cultures, particularly for tracheal aspirates (p<0.05), were associated with longer ICU length of stay and mortality. Early empirical antibiotic use was not associated with mortality (odds ratio 2.5; 95% confidence interval 0.95 - 6.81). CONCLUSIONS: Bacterial coinfection was uncommon in patients at the time of admission to the ICU with severe COVID-19. Avoiding early empirical antibiotic therapy is therefore reasonable. Strategies to avoid coinfection and outbreaks in hospital, such as infection prevention and control, as well as the strict use of personal protective equipment, are important to improve outcomes.


Asunto(s)
Antibacterianos/administración & dosificación , Infecciones Bacterianas/tratamiento farmacológico , COVID-19/complicaciones , Unidades de Cuidados Intensivos , Adulto , Bacterias/aislamiento & purificación , Infecciones Bacterianas/epidemiología , Infecciones Bacterianas/microbiología , Humanos , Prescripción Inadecuada , Tiempo de Internación , Persona de Mediana Edad , Neumonía Viral , Pautas de la Práctica en Medicina , Estudios Prospectivos , Sudáfrica
7.
Bol Med Hosp Infant Mex ; 78(4): 251-258, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34351892

RESUMEN

INTRODUCCIÓN: Hasta ahora existen pocos estudios sobre las características clínicas de la población pediátrica con neumonía por COVID-19. El objetivo de este estudio fue analizar los datos que se asocian con el desarrollo de neumonía en niños y adolescentes con infección por SARS-CoV-2 en México. MÉTODOS: Se llevó a cabo un análisis secundario de la base de datos de la Dirección General de Epidemiología del Gobierno Mexicano. Se incluyeron menores de 19 años con infección por SARS-CoV-2 confirmada mediante la prueba de retrotranscripción acoplada a la reacción en cadena de la polimerasa (RT-PCR). La variable dependiente fue el diagnóstico de neumonía. Se calcularon las razones de momios (RM) y los intervalos de confianza del 95% (IC95%). Se realizaron modelos de regresión logística múltiple para ajustar los factores asociados a neumonía. RESULTADOS: Se incluyeron 1443 niños con diagnóstico de COVID-19. La mediana de edad de los participantes fue de 12 años (rango intercuartilar 25-75: 5-16). La neumonía se presentó en 141 niños (9.8%). Los principales factores de riesgo fueron edad < 3 años (RM: 3.5; IC95%: 2.45-5.03), diabetes u obesidad (RM: 12.6; IC95%: 4.62-34.91) e inmunocompromiso (RM: 7.03; IC95%: 3.97-13.61). CONCLUSIONES: Los niños con COVID-19 menores de 3 años y con comorbilidad, especialmente diabetes u obesidad, y los inmunocomprometidos presentan mayor riesgo de desarrollar neumonía. BACKGROUND: Currently, there are a few studies on the clinical characteristics of the pediatric population with COVID-19 and pneumonia. This study aimed to analyze data associated with the development of pneumonia in children and adolescents with SARS-CoV-2 infection throughout Mexico. METHODS: We conducted a secondary analysis of the database of the Dirección General de Epidemiología of the Mexican Government. We included children under the age of 19 who were confirmed with SARS-CoV-2 infection by reverse transcription-polymerase chain reaction (RT-PCR) test. The dependent variable was the diagnosis of pneumonia. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated. Multiple logistic regression models were performed to adjust factors associated with pneumonia. RESULTS: A total of 1443 children with a COVID-19 diagnosis were included. The median age of the participants was 12 years (interquartile range 25, 75: 5, 16). Pneumonia occurred in 141 children (9.8%). The main risk factors were age < 3 years (OR, 3.5; 95%CI, 2.45-5.03); diabetes or obesity (OR, 12.6; 95%CI, 4.62-34.91); and immunocompromise (OR, 7.03; 95%CI, 3.97-13.61). CONCLUSIONS: Children < 3 years with COVID-19 and comorbidities, especially diabetes or obesity, and immunocompromised patients have a higher risk of developing pneumonia.


Asunto(s)
COVID-19/epidemiología , Neumonía Viral/epidemiología , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , México/epidemiología , Factores de Riesgo
8.
J Health Organ Manag ; ahead-of-print(ahead-of-print)2021 Aug 23.
Artículo en Inglés | MEDLINE | ID: mdl-34415689

RESUMEN

PURPOSE: The COVID-19 pandemic has changed the way hospitals work. Strategies that were detached from the boundaries of departments and responsibilities in the COVID-19 pandemic have proven themselves under extreme conditions and show a beneficial influence on patient flow and resource management as well as on the communication culture. The continuation of closer interdisciplinary and cross-sectoral co-operation in a "new clinical routine" could have a positive impact on personnel concepts, communication strategies, and the management of acute care capacities and patient pathways. DESIGN/METHODOLOGY/APPROACH: The aim of the paper is to critically discuss the knowledge gained in the context of the COVID-19 pandemic from the various approaches in patient flow and capacity management as well as interdisciplinary co-operation. More recent research has evaluated patient pathway management, personnel planning and communication measures with regard to their effect and practicability for continuation in everyday clinical practice. FINDINGS: Patient flows and acute care capacities can be more efficiently managed by continuing a culture change towards closer interdisciplinary and intersectoral co-operation and technologies that support this with telemedicine functionalities and regional healthcare data interoperability. Together with a bi-directional, more frequent and open communication and feedback culture, it could form a "new clinical routine". ORIGINALITY/VALUE: This paper discusses a holistic approach on the way away from silo thinking towards cross-departmental collaboration.


Asunto(s)
COVID-19/epidemiología , Conducta Cooperativa , Administración Hospitalaria , Neumonía Viral/epidemiología , Flujo de Trabajo , Femenino , Humanos , Masculino , Pandemias , Neumonía Viral/virología , SARS-CoV-2
9.
Biomed Res Int ; 2021: 9987931, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34423043

RESUMEN

Objective: Respiratory failure is the leading cause of mortality in COVID-19 patients, characterized by a generalized disbalance of inflammation. The aim of this study was to investigate the relationship between immune-inflammatory index and mortality in PSI IV-V patients with COVID-19. Methods: We retrospectively reviewed the medical records of COVID-19 patients from Feb. to Apr. 2020 in the Zhongfa Xincheng Branch of Tongji Hospital, Wuhan, China. Patients who presented high severity of COVID-19-related pneumonia were enrolled for further analysis according to the Pneumonia Severity Index (PSI) tool. Results: A total of 101 patients diagnosed with COVID-19 were identified at initial research. The survival analysis revealed that mortality of the PSI IV-V cohort was significantly higher than the PSI I-III group (p = 0.0003). The overall mortality in PSI IV-V patients was 32.1% (9/28). The fatal cases of the PSI IV-V group had a higher level of procalcitonin (p = 0.022) and neutrophil-to-lymphocyte ratio (p = 0.033) compared with the survivors. Procalcitonin was the most sensitive predictor of mortality for the severe COVID-19 population with area under receiver operating characteristic curve of 0.78, higher than the neutrophil-to-lymphocyte ratio (0.75) and total lymphocyte (0.68) and neutrophil (0.67) counts. Conclusion: Procalcitonin and neutrophil-to-lymphocyte ratio may potentially be effective predictors for mortality in PSI IV-V patients with COVID-19. Increased procalcitonin and neutrophil-to-lymphocyte ratio were associated with greater risk of mortality.


Asunto(s)
COVID-19/inmunología , COVID-19/fisiopatología , Pandemias , SARS-CoV-2 , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , COVID-19/mortalidad , China/epidemiología , Estudios de Cohortes , Femenino , Humanos , Inflamación/inmunología , Inflamación/fisiopatología , Linfocitos/inmunología , Masculino , Persona de Mediana Edad , Neutrófilos/inmunología , Neumonía Viral/inmunología , Neumonía Viral/mortalidad , Neumonía Viral/fisiopatología , Polipéptido alfa Relacionado con Calcitonina/sangre , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Análisis de Supervivencia
10.
Zhongguo Yi Liao Qi Xie Za Zhi ; 45(4): 384-389, 2021 Jul 30.
Artículo en Chino | MEDLINE | ID: mdl-34363362

RESUMEN

In order to improve the level of epidemic prevention and control, and strengthen the observation and monitoring of potential patients with viral pneumonia in isolated state, a medical intelligent monitoring collar based on DA14699 Bluetooth low-power chip was proposed. DA14699 chip is used as the main controller in the design scheme, and the temperature, cough and location information of potential patients are recorded and analyzed by its high-efficiency wireless multi-core processing ability. The LIS3DH three-axis acceleration sensor is used to judge the cough symptoms. The MLX90640 infrared sensor is used to continuously measure the body temperature. The L218 four frequency GSM / GPRS positioning module is used to complete the rapid and accurate positioning of personnel, so as to realize the comprehensive supervision of the implementation of home isolation measures. DA14699 chip supports Bluetooth BLE5.1 protocol. Epidemic prevention personnel can transmit and read the data recorded in the smart collar from a long distance, and display it directly on the intelligent Bluetooth handheld terminal, effectively avoid the risk of infection caused by close contact. Through the actual test, the monitoring function of the key parameters of the collar is reliable and has high application value.


Asunto(s)
Neumonía Viral , Humanos , Monitoreo Fisiológico
11.
Medicine (Baltimore) ; 100(29): e26533, 2021 Jul 23.
Artículo en Inglés | MEDLINE | ID: mdl-34398008

RESUMEN

ABSTRACT: The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2, keeps spreading globally. Evidence suggests that a subgroup of patients with severe symptomatology might have cytokine storms, which increases mortality. The use of interleukin-6 (IL-6) inhibitors may help in controlling the pathological immune response to the virus. Tocilizumab, a monoclonal antibody against IL-6, stands as an optional treatment for COVID-19 patients presenting this inflammatory hyper-response.We conducted a retrospective, observational, cohort study including 50 patients affected by COVID-19 with severe pneumonia and poor prognosis criteria, who have also undergone standard treatment; 36 of these patients additionally received tocilizumab in an early stage. The need for intensive care unit (ICU) admission, mortality, recovery of respiratory function, and improvement of biochemical and hematological parameters were compared between cohorts.Most patients were men, non-smokers and the most frequently reported comorbidities were hypertension and diabetes. Recurrent symptoms were fever, cough, and dyspnoea. 54.8% of patients from the tocilizumab group needed intubation, while in the control group 85.7% needed it. Treatment with tocilizumab significatively increased IL-6 levels, (554.45; CI 95% 186.69, 1032.93; P < .05) while C-reactive protein mean levels were reduced (-108.19; CI 95% -140.15, -75.33; P < .05), but no significant difference was found between cohorts. In comparison with the controls, tocilizumab reduced mortality (25.0% vs 42.9%, P = .021) and the number of ICU admissions (63.9% vs 100.0%, P = .021). 44.1% of patients treated with tocilizumab showed favorable radiological evolution, when compared with 15.4% of patients from the control group.Tocilizumab may improve clinical symptoms and mitigate deterioration observed in severe COVID-19 patients, and could be considered as an effective therapeutic option in subjects experiencing a significant inflammatory response to the disease.


Asunto(s)
Anticuerpos Monoclonales Humanizados/uso terapéutico , COVID-19/tratamiento farmacológico , Unidades de Cuidados Intensivos/estadística & datos numéricos , Interleucina-6/antagonistas & inhibidores , Neumonía Viral/tratamiento farmacológico , Adulto , Anciano , Anciano de 80 o más Años , COVID-19/complicaciones , COVID-19/diagnóstico , COVID-19/mortalidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neumonía Viral/diagnóstico , Neumonía Viral/etiología , Neumonía Viral/mortalidad , Pronóstico , Estudios Retrospectivos
12.
World J Pediatr ; 17(4): 375-384, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34341947

RESUMEN

BACKGROUND: Severe cases of coronavirus disease 2019 (COVID-19) among pediatric patients are more common in children less than 1 year of age. Our aim is to address the underlying role of immunity and inflammation conditions among different age groups of pediatric patients. METHODS: We recruited pediatric patients confirmed of moderate COVID-19 symptoms, admitted to Wuhan Children's Hospital from January 28th to April 1st in 2020. Patients were divided into four age groups (≤ 1, 1-6, 7-10, and 11-15 years). Demographic information, clinical characteristics, laboratory results of lymphocyte subsets test, immune and inflammation related markers were all evaluated. RESULTS: Analysis included 217/241 (90.0%) of patients with moderate clinical stage disease. Average recovery time of children more than 6 years old was significantly shorter than of children younger than 6 years (P = 0.001). Reduced neutrophils and increased lymphocytes were significantly most observed among patients under 1 year old (P < 0.01). CD19+ B cells were the only significantly elevated immune cells, especially among patients under 1 year old (cell proportion: n = 12, 30.0%, P < 0.001; cell count: n = 13, 32.5%, P < 0.001). While, low levels of immune related makers, such as immunoglobulin (Ig) G (P < 0.001), IgA (P < 0.001), IgM (P < 0.001) and serum complement C3c (P < 0.001), were also mostly found among patients under 1 year old, together with elevated levels of inflammation related markers, such as tumor necrosis factor γ (P = 0.007), interleukin (IL)-10 (P = 0.011), IL-6 (P = 0.008), lactate dehydrogenase (P < 0.001), and procalcitonin (P = 0.007). CONCLUSION: The higher rate of severe cases and long course of COVID-19 among children under 1 year old may be due to the lower production of antibodies and serum complements of in this age group.


Asunto(s)
COVID-19/inmunología , Neumonía Viral/inmunología , SARS-CoV-2/inmunología , Síndrome de Respuesta Inflamatoria Sistémica/inmunología , Adolescente , Biomarcadores/sangre , COVID-19/epidemiología , Niño , Preescolar , China/epidemiología , Citocinas/inmunología , Femenino , Hospitales Pediátricos , Humanos , Lactante , Subgrupos Linfocitarios , Masculino , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/virología , Índice de Severidad de la Enfermedad , Síndrome de Respuesta Inflamatoria Sistémica/epidemiología
13.
Crit Rev Biomed Eng ; 49(1): 21-33, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34347985

RESUMEN

The outbreak of coronavirus disease 2019 (COVID-19) has resulted in a world-wide crisis. To contain the virus, it is important to find infected individuals and isolate them to stop transmission. Various diagnostic techniques are used to check for infection. With the havoc that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has created, it is imperative to work on alternative diagnostic techniques that can be used at both point of care with little or no expertise and at mass testing (i.e., when screening). Despite extensive research, to this date no specific effective treatment or cure is available to neutralize this viral infection. Globally, researchers are working to develop effective treatments, and several vaccines have been approved for public use. We found the studies that we explored for this review using appropriate key words for indexing in PubMed and Google Scholar from 2019 to 2020. We compile various techniques that have been used worldwide to diagnose and treat SARS-CoV-2 and discuss novel methods that may be modified for use in diagnosis and treatment. It is crucial to develop a more specific serological test for diagnosis that can rule out the possibility of COVID-19 and be used for mass testing. An affordable, safe, targeted, effective treatment must be developed to cure this disease, which has created a public health emergency of international concern.


Asunto(s)
Prueba de COVID-19/tendencias , COVID-19/diagnóstico , COVID-19/terapia , Salud Global , Neumonía Viral/diagnóstico , Neumonía Viral/terapia , Vacunas contra la COVID-19 , Humanos , Pandemias , SARS-CoV-2
14.
Dan Med J ; 68(8)2021 Jul 12.
Artículo en Inglés | MEDLINE | ID: mdl-34356014

RESUMEN

INTRODUCTION: Viral pneumonia is a common cause of hospital admission among Danish children. However, it remains unknown how many admissions among Danish children may be ascribed to viral pneumonia overall. METHODS: Based on data drawn from the National Patient Register and the Danish Microbiology Database, hospital admissions for viral pneumonia and asthma-like disease were investigated among Danish children and adolescents less than 18 years. Testing of admitted patients for respiratory syncytial virus (RSV) and influenza virus was also considered. RESULTS: A total of 5,218 admissions with a diagnosis of viral pneumonia were identified among Danish children and adolescents less than 18 years from 2012 to 2016. During the same period, 63,731 tests were conducted during hospital admission for RSV or influenza virus, which produced 9,933 positive tests for RSV and 3,287 for influenza. In addition, 43,213 admissions were due to asthma-like disease. CONCLUSIONS: The present study documented overlapping age and seasonal epidemiological patterns of different measures of viral pneumonia among Danish children and presented how the collection of data from different sources (diagnoses and diagnostic tests) yielded a more complete picture of the burden of hospital contacts among Danish children and adolescents caused by viral pneumonia. Viral pneumonia is a very common cause of hospital admission among Danish children and adolescents. FUNDING: No specific funding was available for the present project. TRIAL REGISTRATION: not relevant.


Asunto(s)
Asma , Neumonía Viral , Virus Sincitial Respiratorio Humano , Adolescente , Niño , Dinamarca/epidemiología , Hospitalización , Humanos , Lactante , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología
15.
Adv Emerg Nurs J ; 43(3): 194-197, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34397495

RESUMEN

COVID-19 is a major health issue, and patients with underlying conditions are more susceptible to catastrophic outcomes. Toxic epidermal necrolysis (TEN) is a severe systemic disease caused by an immune system hypersensitive reaction. We present a case of TEN induced following sulfasalazine administration that later on complicated with COVID-19, deep vein thrombosis, pulmonary emboli, and eventually death.


Asunto(s)
Antirreumáticos/efectos adversos , Artritis Reumatoide/tratamiento farmacológico , COVID-19/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Síndrome de Stevens-Johnson/etiología , Sulfasalazina/efectos adversos , Resultado Fatal , Femenino , Humanos , Persona de Mediana Edad , Pandemias , SARS-CoV-2
16.
BMC Pulm Med ; 21(1): 267, 2021 Aug 17.
Artículo en Inglés | MEDLINE | ID: mdl-34404383

RESUMEN

BACKGROUND: The aim of the study is to estimate the prevalence of atelectasis assessed with computer tomography (CT) in SARS-CoV-2 pneumonia and the relationship between the amount of atelectasis with oxygenation impairment, Intensive Care Unit admission rate and the length of in-hospital stay. PATIENTS AND METHODS: Two-hundred thirty-seven patients admitted to the hospital with SARS-CoV-2 pneumonia diagnosed by clinical, radiology and molecular tests in the nasopharyngeal swab who underwent a chest computed tomography because of a respiratory worsening from Apr 1 to Apr 30, 2020 were included in the study. Patients were divided into three groups depending on the presence and amount of atelectasis at the computed tomography: no atelectasis, small atelectasis (< 5% of the estimated lung volume) or large atelectasis (> 5% of the estimated lung volume). In all patients, clinical severity, oxygen-therapy need, Intensive Care Unit admission rate, the length of in-hospital stay and in-hospital mortality data were collected. RESULTS: Thirty patients (19%) showed small atelectasis while eight patients (5%) showed large atelectasis. One hundred and seventeen patients (76%) did not show atelectasis. Patients with large atelectasis compared to patients with small atelectasis had lower SatO2/FiO2 (182 vs 411 respectively, p = 0.01), needed more days of oxygen therapy (20 vs 5 days respectively, p = 0,02), more frequently Intensive Care Unit admission (75% vs 7% respectively, p < 0.01) and a longer period of hospitalization (40 vs 14 days respectively p < 0.01). CONCLUSION: In patients with SARS-CoV-2 pneumonia, atelectasis might appear in up to 24% of patients and the presence of larger amount of atelectasis is associated with worse oxygenation and clinical outcome.


Asunto(s)
COVID-19 , Hipoxia , Neumonía Viral , Atelectasia Pulmonar , Tomografía Computarizada por Rayos X/métodos , Anciano , COVID-19/diagnóstico , COVID-19/mortalidad , COVID-19/fisiopatología , Prueba de COVID-19/métodos , Femenino , Humanos , Hipoxia/etiología , Hipoxia/terapia , Unidades de Cuidados Intensivos/estadística & datos numéricos , Tiempo de Internación/estadística & datos numéricos , Pulmón/diagnóstico por imagen , Mediciones del Volumen Pulmonar/métodos , Masculino , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/etiología , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , Prevalencia , Atelectasia Pulmonar/diagnóstico por imagen , Atelectasia Pulmonar/epidemiología , Atelectasia Pulmonar/etiología , Atelectasia Pulmonar/fisiopatología , Respiración Artificial/métodos , Respiración Artificial/estadística & datos numéricos , Estudios Retrospectivos , SARS-CoV-2/aislamiento & purificación , Índice de Severidad de la Enfermedad , España/epidemiología , Tomografía Computarizada por Rayos X/estadística & datos numéricos
17.
BMC Pregnancy Childbirth ; 21(1): 587, 2021 Aug 26.
Artículo en Inglés | MEDLINE | ID: mdl-34445988

RESUMEN

BACKGROUND: The coronavirus disease (COVID-19) pandemic has caused ongoing challenges in health services worldwide. Despite the growing body of literature on COVID-19, reports on perinatal care in COVID-19 cases are limited. CASE PRESENTATION: We describe a case of severe acute respiratory distress syndrome (ARDS) in a 36-year-old G5/P2 pregnant woman with morbid obesity, confirmed severe acute respiratory syndrome coronavirus 2 infection, and fulminant respiratory failure. At 28+ 1 gestational weeks, the patient delivered an uninfected newborn. Using ImmunoCAP ISAC® technology, we found no immunoglobulin (Ig) M antibodies, suggesting that no mother-to-child viral transmission occurred during pregnancy or delivery. The maternal respiratory state improved rapidly after delivery; both maternal and neonatal outcomes were encouraging given the early gestational age and fulminant course of respiratory failure in our patient. CONCLUSIONS: The management of ARDS in pregnant women with COVID-19 is complex and requires an individualized, multidisciplinary approach, while considering maternal and fetal outcomes.


Asunto(s)
COVID-19 , Cesárea/métodos , Neumonía Viral , Complicaciones Infecciosas del Embarazo , Nacimiento Prematuro , Síndrome de Dificultad Respiratoria , SARS-CoV-2/aislamiento & purificación , Adulto , COVID-19/complicaciones , COVID-19/diagnóstico , Femenino , Monitoreo Fetal/métodos , Edad Gestacional , Humanos , Obesidad Mórbida/diagnóstico , Obesidad Mórbida/fisiopatología , Grupo de Atención al Paciente/organización & administración , Atención Perinatal/métodos , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/etiología , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/fisiopatología , Complicaciones Infecciosas del Embarazo/terapia , Complicaciones Infecciosas del Embarazo/virología , Resultado del Embarazo , Nacimiento Prematuro/etiología , Nacimiento Prematuro/terapia , Respiración Artificial/métodos , Síndrome de Dificultad Respiratoria/diagnóstico , Síndrome de Dificultad Respiratoria/etiología , Síndrome de Dificultad Respiratoria/fisiopatología , Síndrome de Dificultad Respiratoria/terapia , Resultado del Tratamiento
18.
Crit Care ; 25(1): 224, 2021 06 30.
Artículo en Inglés | MEDLINE | ID: mdl-34193220

RESUMEN

BACKGROUND: Previous studies reporting the causes of death in patients with severe COVID-19 have provided conflicting results. The objective of this study was to describe the causes and timing of death in patients with severe COVID-19 admitted to the intensive care unit (ICU). METHODS: We performed a retrospective study in eight ICUs across seven French hospitals. All consecutive adult patients (aged ≥ 18 years) admitted to the ICU with PCR-confirmed SARS-CoV-2 infection and acute respiratory failure were included in the analysis. The causes and timing of ICU deaths were reported based on medical records. RESULTS: From March 1, 2020, to April 28, 287 patients were admitted to the ICU for SARS-CoV-2 related acute respiratory failure. Among them, 93 patients died in the ICU (32%). COVID-19-related multiple organ dysfunction syndrome (MODS) was the leading cause of death (37%). Secondary infection-related MODS accounted for 26% of ICU deaths, with a majority of ventilator-associated pneumonia. Refractory hypoxemia/pulmonary fibrosis was responsible for death in 19% of the cases. Fatal ischemic events (venous or arterial) occurred in 13% of the cases. The median time from ICU admission to death was 15 days (25th-75th IQR, 7-27 days). COVID-19-related MODS had a median time from ICU admission to death of 14 days (25th-75th IQR: 7-19 days), while only one death had occurred during the first 3 days since ICU admission. CONCLUSIONS: In our multicenter observational study, COVID-19-related MODS and secondary infections were the two leading causes of death, among severe COVID-19 patients admitted to the ICU.


Asunto(s)
COVID-19/mortalidad , Insuficiencia Multiorgánica/mortalidad , Neumonía Viral/mortalidad , Adulto , Causas de Muerte , Femenino , Mortalidad Hospitalaria , Humanos , Hipoxia/mortalidad , Hipoxia/virología , Unidades de Cuidados Intensivos , Isquemia/mortalidad , Isquemia/virología , Masculino , Insuficiencia Multiorgánica/virología , Neumonía Asociada al Ventilador/mortalidad , Neumonía Asociada al Ventilador/virología , Neumonía Viral/virología , Fibrosis Pulmonar/mortalidad , Fibrosis Pulmonar/virología , Estudios Retrospectivos , SARS-CoV-2
19.
Crit Care ; 25(1): 223, 2021 06 30.
Artículo en Inglés | MEDLINE | ID: mdl-34193235

RESUMEN

BACKGROUND: Thiamine is a precursor of the essential coenzyme thiamine pyrophosphate required for glucose metabolism; it improves the immune system function and has shown to reduce the risk of several diseases. The role of thiamine in critically ill septic patient has been addressed in multiple studies; however, it's role in COVID-19 patients is still unclear. The aim of this study was to evaluate the use of thiamine as an adjunctive therapy on mortality in COVID-19 critically ill patients. METHODS: This is a two-center, non-interventional, retrospective cohort study for critically ill patients admitted to intensive care units (ICUs) with a confirmed diagnosis of COVID19. All patients aged 18 years or older admitted to ICUs between March 1, 2020, and December 31, 2020, with positive PCR COVID-19 were eligible for inclusion. We investigated thiamine use as an adjunctive therapy on the clinical outcomes in critically ill COVID-19 patients after propensity score matching. RESULTS: A total of 738 critically ill patients with COVID-19 who had been admitted to ICUs were included in the study. Among 166 patients matched using the propensity score method, 83 had received thiamine as adjunctive therapy. There was significant association between thiamine use with in-hospital mortality (OR = 0.39; 95% CI 0.19-0.78; P value = 0.008) as well as the 30-day mortality (OR = 0.37; 95% CI 0.18-0.78; P value = 0.009). Moreover, patients who received thiamine as an adjunctive therapy were less likely to have thrombosis during ICU stay [OR (95% CI) 0.19 (0.04-0.88), P value = 0.03]. CONCLUSION: Thiamine use as adjunctive therapy may have potential survival benefits in critically ill patients with COVID-19. Additionally, it was associated with a lower incidence of thrombosis. Further interventional studies are required to confirm these findings.


Asunto(s)
COVID-19/tratamiento farmacológico , COVID-19/mortalidad , Enfermedad Crítica/mortalidad , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/mortalidad , Tiamina/uso terapéutico , Adulto , Femenino , Mortalidad Hospitalaria , Humanos , Unidades de Cuidados Intensivos , Masculino , Puntaje de Propensión , Estudios Retrospectivos , Factores de Riesgo , SARS-CoV-2 , Trombosis/prevención & control
20.
Comput Math Methods Med ; 2021: 5528144, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34194535

RESUMEN

Pneumonia is an infamous life-threatening lung bacterial or viral infection. The latest viral infection endangering the lives of many people worldwide is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19. This paper is aimed at detecting and differentiating viral pneumonia and COVID-19 disease using digital X-ray images. The current practices include tedious conventional processes that solely rely on the radiologist or medical consultant's technical expertise that are limited, time-consuming, inefficient, and outdated. The implementation is easily prone to human errors of being misdiagnosed. The development of deep learning and technology improvement allows medical scientists and researchers to venture into various neural networks and algorithms to develop applications, tools, and instruments that can further support medical radiologists. This paper presents an overview of deep learning techniques made in the chest radiography on COVID-19 and pneumonia cases.


Asunto(s)
Prueba de COVID-19/métodos , COVID-19/diagnóstico por imagen , Aprendizaje Profundo , SARS-CoV-2 , Algoritmos , COVID-19/diagnóstico , Prueba de COVID-19/estadística & datos numéricos , Biología Computacional , Diagnóstico Diferencial , Humanos , Conceptos Matemáticos , Redes Neurales de la Computación , Neumonía Viral/diagnóstico , Neumonía Viral/diagnóstico por imagen , Radiografía Torácica/estadística & datos numéricos , Tomografía Computarizada por Rayos X/estadística & datos numéricos
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...